PDF | The technique for endobutton femoral fixation of double semitendinosus/ double gracilis hamstring anterior cruciate ligament (ACL). Find out all of the information about the Smith & Nephew product: ACL reconstruction suture button ENDOBUTTON. Contact a supplier or the parent company. ACL reconstruction performed using a transtibial tunnel technique often .. to be inserted into the ACL femoral socket when using a 15 mm ENDOBUTTON CL.

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Cross pins versus endobutton femoral fixation in hamstring anterior cruciate ligament reconstruction: The yield loading displayed by both fixations was sufficient to support the loading applied during daily tasks and accelerated rehabilitation programs. Postoperative anteroposterior radiograph of a right Rt knee showing reduced EndoButton to lateral aspect of femoral cortex. This method is easy to use, is reproducible and has been shown to be independent of knee size, shape and the distance between the X-ray tube and the patient [ 15 ].

Mechanical behavior of two hamstring graft constructs for reconstruction of the anterior cruciate ligament. The tip of the ACL tip aimer is positioned slightly anterior to the posterior margin of the anterior horn of the lateral meniscus and slightly medial to the midline of the tibial footprint.

Abstract Suture button—based techniqeu cortical suspension constructs of anterior cruciate ligament grafts can facilitate a fast and secure fixation.

ACL Technique: Endoscopic Hamstring Graft with Endobutton

Dressings are applied and the patient is returned to the recovery area. A probe can be inserted through the same portal to help manipulate the EndoButton into the proper position at the lateral cortex of the femur by pulling the graft on the tibial side.

It is worth noting that some methods used in this experiment should be highlighted. B Anteroposterior radiograph of a right Rt knee showing reduced position of migrated EndoButtons after arthroscopic reduction. Published online Oct Raise or lower the handle of the tibial guide aimer until the mark on the bullet is located at the end of the aimer handle when the bullet is flush with the anterior cortex of the tibia.


Direct the spinal needle towards the intercondylar notch, adjusting the height of the spinal needle above the medial joint line as needed to ensure that it comes to lie parallel to the roof of the intercondylar notch. The free end of the graft was fixed in the load cell leaving a gage length of 30 mm to mimic the human intra articular ACL length Figure 3.

Several studies have shown that EndoButton malpositioning over the soft tissue around the knee induces either tissue irritation or migration of the button.

The anterolateral AL portal —used as a viewing portal to perform diagnostic arthroscopy and meniscal surgery.

ACL Technique: Endoscopic Hamstring Graft with Endobutton

Am J Knee Surg. Orthopedic Journal of China Make an LF portal by longitudinally extending the guide pin incision. To withdraw the endoscopic reamer, the passing pin is withdrawn from the femoral tunnel, and the reamer manoeuvred into the notch away from the medial femoral condyle and the reamer safely removed from the joint. The anchor point, however, is different.

Tendon healing in a techhnique tunnel. Amis-Jakob line [ 18 ]. Pass the passing sutures for the ACL graft through the suture loop and pass them out of the lateral thigh. Correct angle of knee flexion for tensioning of the ACL graft for different femoral tunnel positions. How to cite this URL: Nau T, Spotswood M. The length of the side wall of the notch is measured where the ACL ruler touches the shallow margin of the articular cartilage Fig.

Slowly drill the 2. This paper describes the advantages of the medial portal technique, indications for the technique, patient positioning, proper portal placement, anatomical femoral and tibial tunnel placement, graft tensioning and fixation. Positioning the AAM portal more medially results in a more perpendicular orientation of the femoral drill bit with respect to the lateral wall of the notch and produces a shorter ACL femoral tunnel and a more circular-shaped tunnel aperture Fig.


This detailed description should enable surgeons to be confident in their anatomical understanding of ACL reconstructive surgery. Double-bundle reconstruction of the anterior cruciate ligament. However, there are no remnants of the native ACL fibres visible.

Structural properties of six tibial fixation methods for anterior cruciate ligament soft tissue grafts. Iliotibial band irritation caused by the EndoButton after anatomic double-bundle anterior cruciate ligament reconstruction: Other potential problems that can result from drilling the ACL femoral tunnel in hyperflexion include: Second-generation, no-incision anterior cruciate ligament reconstruction.

Chronic ACL-deficient knee with osteophytes along the lateral wall of the intercondylar notch.

Previous studies have shown that the interference screws fixation on tibia is the weak point in ACL reconstruction when Bio Cross-Pin or EndoButton are used at femoral site Shen et al. A prospective ebdobutton of tunnel enlargement in anterior cruciate ligament reconstruction with hamstrings: Anatomical placement of an anterior cruciate ligament ACL graft is considered critical to the success and clinical outcome of ACL reconstruction.

The knee range of motion in Endobutton and Rigidfix were One of the goals of ACL reconstruction is to restore the maximum amount of the tibial and femoral attachment sites. The laxity techniqye cyclic loading and the displacement to failure during single-cycle test were lower for the Bio Cross-Pin fixation 8. At present, intra-operative fluoroscopy is the most accurate method to measure and document ACL femoral technqiue placement [ 1314 ].